Md. Code Regs. 10.09.96.02

Current through Register Vol. 51, No. 22, November 1, 2024

Section 10.09.96.02 - Definitions

A. In this chapter, the following terms have the meanings indicated.

B. Terms Defined.

(1) "Certified nurse midwife" means an individual who meets the licensure and conditions of participation for certified nurse midwives set forth in COMAR 10.09.01.

(2) "Certified nurse practitioner" means an individual who meets the licensure and conditions of participation for certified nurse practitioners set forth in COMAR 10.09.01.

(3) "Department" means the Maryland Department of Health, which is the single State agency designated to administer the remote patient monitoring program.

(4) "Episode" means the span of treatment during which remote patient monitoring services are rendered to eligible participants.

(5) "Home" means the place of residence occupied by the participant, other than a hospital, nursing facility, or other medical or psychiatric institution.

(6) "Home health agency" means a public or private agency or organization that meets the licensure requirements and conditions of participation of COMAR 10.09.04.

(7) "Maryland Medical Assistance Program" means the program of comprehensive medical, behavioral, and other health-related care for indigent and medically indigent individuals, jointly financed by the federal and state governments and administered by states under Title XTK of the Social Security Act, 42 U.S.C § 1396 et seq., as amended.

(8) "Medically necessary" means that the service or benefit is:

(a) Directly related to diagnostic, preventive, curative, palliative, rehabilitative, or ameliorative treatment of an illness, injury, disability, or health condition;

(b) Consistent with currently accepted standards of good medical practice;

(c) The most cost-efficient service that can be provided without sacrificing effectiveness or access to care; and

(d) Not primarily for the convenience of the consumer, family, or provider.

(9) "Participant" means an individual who is certified as eligible for, and is receiving, Medical Assistance benefits.

(10) "Physician " means an individual who meets the licensure requirements and conditions of participation of COMAR 10.09.02.

(11) "Physician assistant" means an individual who meets the licensure requirements and conditions of participation set forth in COMAR 10.09.55.

(12) "Program" means the Maryland Medical Assistance Program.

(13) "Provider" means an individual or an organization who:

(a) Meets the requirements of Regulations . 03 and. 04 of this chapter; and

(b) Through an appropriate agreement with the Department, has been identified as a Program provider by the issuance of a unique provider number.

(14) "Remote patient monitoring" means the use of synchronous or asynchronous digital technologies that collect or monitor medical, patient-reported, and other forms of health care data for Program participants at an originating site and electronically transmit that data to a distant site provider to enable the distant site provider to assess, diagnose, consult, treat, educate, provide care management, suggest self-management, or make recommendations regarding the Program participant's health care.

Md. Code Regs. 10.09.96.02

Regulation .02 adopted effective 44:26 Md. R. 1215, eff. 1/1/2018; amended effective 50:14 Md. R. 593, eff. 7/24/2023